MEDICARE: MRS. ERIKA MARLENE NIETO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	91064	TX

General Provider Information

NPI Number	:	1548101900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIKA MARLENE NIETO LPC

Provider Business Mailing Address
First Line	:	14243 TRIGGER ROCK LN
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-2830
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5625 WOODROW BEAN STE 124
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-4143
Country	:	US
Telephone Number	:	915-202-5778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2026
Last Update Date	:	04/01/2026

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